Show Chwan Memorial Hospital

Changhua, Taiwan

Show Chwan Memorial Hospital

Changhua, Taiwan
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BACKGROUND: Positron emission tomography-computed tomography using F-fluorodeoxyglucose (F-FDG PET/CT) has been widely used in oncology. Vascular invasion of hepatocellular carcinoma (HCC) is associated with a high risk of tumor recurrence and low survival rates after liver transplantation (LT). This retrospective study determined the predictive value of F-FDG PET/CT for vascular invasion in patients with HCC before LT. METHODS: Sixty-five patients with HCC who underwent F-FDG PET/CT before LT were retrospectively included between January 2010 and July 2012. Volumes of interest (VOIs) were drawn for the tumors and normal liver tissues, and the standardized uptake value (SUV) in each VOI was measured. The maximal SUV (SUVmax) of the tumor, the ratio of tumor SUVmax to normal liver SUVmax (TSUVmax/LSUVmax), and the ratio of tumor SUVmax to normal liver SUVmean (TSUVmax/LSUVmean) were measured. The predictive value of metabolic parameters and conventional prognostic factors were analyzed. RESULTS: Vascular invasion was pathologically confirmed in 15 (23.08%) of 65 patients. Compared with patients without vascular invasion, patients with vascular invasion exhibited significantly higher serum alpha-fetoprotein (AFP) (P < 0.001), larger tumor size (P = 0.001), higher tumor number (P = 0.017), and higher SUVmax, TSUVmax/LSUVmax ratio, and higher TSUVmax/LSUVmean ratio (P = 0.008, P = 0.002, and P = 0.006, respectively). Univariate analysis revealed that SUVmax, TSUVmax/LSUVmax ratio, and TSUVmax/LSUVmean ratio of FDG PET/CT were significantly associated with vascular invasion in patients with HCC before LT (P = 0.019, P = 0.018, and P = 0.015, respectively). Multivariate analysis revealed that the TSUVmax/LSUVmean ratio of F-FDG PET/CT was a significant predictor of vascular invasion (P = 0.04) and that the TSUVmax/LSUVmax ratio of F-FDG PET/CT was an independent predictor of vascular invasion, although this finding demonstrated borderline statistical significance (P = 0.06) in patients with HCC before LT. CONCLUSIONS: According to the study results, the TSUVmax/LSUVmean ratio is an independent and significant predictor of vascular invasion, and the TSUVmax/LSUVmax ratio of F-FDG PET/CT is an independent predictor of vascular invasion, which is the main negative outcome after LT. Therefore, FDG PET/CT can provide vital information for determining prognosis and selecting an optimal candidate of LT for HCC. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.


Shieh J.-I.,Asia University, Taiwan | Wu H.-H.,National Changhua University of Education | Huang K.-K.,Asia University, Taiwan | Huang K.-K.,Show Chwan Memorial Hospital
Knowledge-Based Systems | Year: 2010

Since National Health Insurance program formally went into effect in March 1995 in Taiwan, the residents enjoy high quality but relatively cheaper medical care compared with the most developed countries. To manage a hospital successfully, the important goals are to attract and then retain as many patients as possible by meeting potential demands of various kinds of the patients. This study first conducted the survey based on SERVQUAL model to identify seven major criteria from patients' or their families' viewpoints at Show Chwan Memorial Hospital in Changhua City, Taiwan. When the key criteria were found, the second survey developed for applying decision-making trial and evaluation laboratory (DEMATEL) method was issued to the hospital management by evaluating the importance of criteria and constructing the causal relations among the criteria. The results show that trusted medical staff with professional competence of health care is the most important criterion and mutually affects service personnel with good communication skills, service personnel with immediate problem-solving abilities, detailed description of the patient's condition by the medical doctor, and medical staff with professional abilities. Therefore, trainings on communication skills and problem-solving abilities would result in positive interaction for patients to trust medical staff. When the trusted medical staff provides professional competence of health care to patients, satisfaction would be increased. Crown Copyright © 2010.


Lee I.-K.,Kaohsiung Chang Gung Memorial Hospital | Lee I.-K.,Chang Gung University | Liu J.-W.,Kaohsiung Chang Gung Memorial Hospital | Liu J.-W.,Chang Gung University | Yang K.D.,Show Chwan Memorial Hospital
PLoS Neglected Tropical Diseases | Year: 2012

Background: A better description of the clinical and laboratory manifestations of fatal patients with dengue hemorrhagic fever (DHF) is important in alerting clinicians of severe dengue and improving management. Methods and Findings: Of 309 adults with DHF, 10 fatal patients and 299 survivors (controls) were retrospectively analyzed. Regarding causes of fatality, massive gastrointestinal (GI) bleeding was found in 4 patients, dengue shock syndrome (DSS) alone in 2; DSS/subarachnoid hemorrhage, Klebsiella pneumoniae meningitis/bacteremia, ventilator associated pneumonia, and massive GI bleeding/Enterococcus faecalis bacteremia each in one. Fatal patients were found to have significantly higher frequencies of early altered consciousness (≤24 h after hospitalization), hypothermia, GI bleeding/massive GI bleeding, DSS, concurrent bacteremia with/without shock, pulmonary edema, renal/hepatic failure, and subarachnoid hemorrhage. Among those experienced early altered consciousness, massive GI bleeding alone/with uremia/with E. faecalis bacteremia, and K. pneumoniae meningitis/bacteremia were each found in one patient. Significantly higher proportion of bandemia from initial (arrival) laboratory data in fatal patients as compared to controls, and higher proportion of pre-fatal leukocytosis and lower pre-fatal platelet count as compared to initial laboratory data of fatal patients were found. Massive GI bleeding (33.3%) and bacteremia (25%) were the major causes of pre-fatal leukocytosis in the deceased patients; 33.3% of the patients with pre-fatal profound thrombocytopenia (<20000/μL), and 50% of the patients with pre-fatal prothrombin time (PT) prolongation experienced massive GI bleeding. Conclusions: Our report highlights causes of fatality other than DSS in patients with severe dengue, and suggested hypothermia, leukocytosis and bandemia may be warning signs of severe dengue. Clinicians should be alert to the potential development of massive GI bleeding, particularly in patients with early altered consciousness, profound thrombocytopenia, prolonged PT and/or leukocytosis. Antibiotic(s) should be empirically used for patients at risk for bacteremia until it is proven otherwise, especially in those with early altered consciousness and leukocytosis. © 2012 Lee et al.


Lai G.-M.,Changhua Christian Hospital | Yan S.-L.,Show Chwan Memorial Hospital | Chang C.-S.,Changhua Christian Hospital | Tsai C.-Y.,Changhua Christian Hospital
World Journal of Gastroenterology | Year: 2013

Hepatitis B virus (HBV) reactivation is a well-recognized complication in patients with chronic HBV infection receiving cytotoxic or immunosuppressive chemotherapy. Imatinib mesylate and nilotinib are selective Bcr/Abl tyrosine kinase inhibitors, which are now widely used in the treatment of patients with chronic myeloid leukemia. Although HBV reactivation induced by imatinib mesylate has been reported, nilotinib-related HBV reactivation has not been reported in the English literature. We report here 2 cases of HBV reactivation in chronic myeloid leukemia patients receiving imatinib mesylate and a novel case of nilotinib related HBV reactivation. © 2013 Baishideng. All rights reserved.


Chen Y.-F.,Show Chwan Memorial Hospital | Chang J.S.,National Health Research Institute
Molecular Biology Reports | Year: 2012

Psoriasis is a chronic autoimmune skin disease with both environmental and genetic risk factors. Previous studies of the association between psoriasis and PTPN22 C1858T (rs2476601), a gain of function variant associated with a stronger inhibitory effect of T-lymphocytes, have produced inconsistent results. The purpose of the current study is to evaluate the association between PTPN22 C1858T and psoriasis using meta-analysis to: (1) have a sufficient sample size for detecting a weak association; and (2) to explore the heterogeneity between studies. A meta-analysis based on random-effects model was performed with ten studies (3,334 psoriasis cases and 5,753 controls) identified from a literature search. A non-significantly positive association between psoriasis and the PTPN22 T1858 was observed [summary allelic odds ratio (OR) = 1.15, 95 % confidence interval (CI): 1.00-1.33] and the association appears stronger among subjects with psoriatic arthritis (summary allelic OR = 1.23, 95 % CI: 1.00-1.52). A null association between PTPN22 T1858 and early-onset psoriasis was observed (summary allelic OR = 1.08, 95 % CI: 0.92-1.28). The current analysis showed a non-significantly positive association between psoriasis and the PTPN22 T1858 allele, and the association appeared stronger among subjects with psoriatic arthritis. Future studies of psoriasis should incorporate gene-environment interaction in the analysis and pay attention to the heterogeneity of psoriasis cases and bias associated with population stratification. © 2012 Springer Science+Business Media B.V.


Lai H.-C.,Show Chwan Memorial Hospital
Pediatrics and Neonatology | Year: 2010

Gastrointestinal symptoms in Henoch-Schönlein purpura (HSP) are common and occur in about two-thirds of HSP patients. Surgical intervention is only required in a minority of cases. Intussusception is a rare complication and the most common surgical indication for HSP. We report a 3-year-old boy with HSP and clinical manifestations of palpable skin rash lasting for 4 days, fever for 3 days, intermittent abdominal cramping pain, and left ankle arthralgia lasting for several hours. Abdominal sonography revealed characteristic signs of intussusception including a doughnut sign and a pseudo-kidney sign in the right upper quadrant of the abdomen. After unsuccessful initial reduction by air enema, surgical reduction was arranged and manual reduction of the ileocecal intussusception without bowel resection was carried out. © 2010 Taiwan Pediatric Association.


Lai H.-C.,Show Chwan Memorial Hospital
Pediatrics and Neonatology | Year: 2010

Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract and represents a persistent remnant of the omphalomesenteric duct. The most common clinical presentation is intermittent and painless rectal bleeding, followed by intestinal obstruction. Intestinal obstruction due to Meckel's enterolith is rarely reported in children. We report a patient who presented with ileus secondary to fecalith impaction of Meckel's diverticulum, causing intestinal obstruction and diverticulitis. © 2010 Taiwan Pediatric Association.


A tGal-3BP-Fc fusion protein, a pharmaceutical composition, an isolated nucleic acid, a recombinant expression vector, and a method of inhibiting, decreasing, reducing, suppressing or limiting metastasis of cancer cells, and immunosuppressing or modulating phagocytosis and T-cell functions by using the same are disclosed herein. The tGal-3BP-Fc fusion protein comprises: a truncated Gal-3 binding protein with domain 4, and at least an Fc fragment of an immunoglobulin G. A pharmaceutical composition comprises the tGal-3BP-Fc or Fc-tGal-3BP fusion protein, and a pharmaceutically acceptable carrier. The method comprises a step of administrating the pharmaceutical composition to a subject in a therapeutically effective amount to inhibit, decrease, reduce, suppress or limit invasiveness and metastasis of cancer cells or to treat or modulate immune reactions of inflammatory diseases in the subject.


Patent
Show Chwan Memorial Hospital | Date: 2012-10-26

An X-ray imaging system for generating space transfer functions has an X-ray machine, a check board and a host. The X-ray machine has an X-ray camera and an image camera to respectively take an X-ray image and a reference image for a calibration pattern on the check board. The host has a controller electrically connected to the X-ray camera and the image camera to receive the X-ray image and the reference image. The controller generates parameters and space transfer functions according to the X-ray image and the reference image. The check board of the present invention is easy to be manufactured and is convenient to use in an X-ray imaging machine


Patent
Show Chwan Memorial Hospital | Date: 2013-03-15

An image enhancement method for improving color perception of colorblind viewers has an image input step, an image difference area analyzing step, an image color distribution adjusting step, and an image output step. In such method, a normal image and a colorblindness-simulative image are input and calculated to produce a colorblindness-optimized image. Color vision obtained by a colorblind person from the colorblindness-optimized image is substantially identical to that obtained by a person with normal color perception from the normal image.

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